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California State University Long Beach ̱бCalifornia State University Long Beach
Ȩ л, ȯ, ýĮ, Ʈ, ⱹϽô ݰ е ϽǼ ִ Դϴ.
Ͻø û ۼ ֽðų ̸ ֽø ˴ϴ.
ǽð Ͻø MSN ȭ ߰ ֽø ܱ ô Ǹ ϽǼ ֽϴ.

  

 

 

California State University Long Beach   ǥԴϴ

 

 

 

 

Insurance  Provider

 

б

DBغ

 

Lifetime Maximum

 

$250,000

Unlimited

 

Benefit

 

 $250,000 

 

$50,000 per Sickness or Injury

Deductible

 

δ

$100

$0

 

º̿/ȸδ

 

PPO      :  90%

100%

 

º/ȸδ

 

Non-PPO  : 75%

100%

 

Annual Out-of-Pocket Maximum

 

Ⱓ δؾϴ δ

 

$2,500/insured person/year

δݾ

 

 

Prescription Drug

 

(పδ)

 

PPO: 10% δ

ѵ

δ

Non-PPO:50% δ

 

Premium

(Annual)

 

Student age 24 and under

 

Student: $843

Spouse $ 3,039

 

Per Child age 18 and under

 

    Child: $ 1,521

 

 

 

 

 

Student: $480

Spouse:$480

Child:$480

 

 

 

 

 

 

 

 

 

 

 

 

 



 

 

 

 

   б޺

 

1.   δ: Deductible δؾ ϴ ٴ ǹմϴ.

 Deductible :  $100 

 

 

2. κп  PPO : 90% Non-PPO  : 75%:  

PPO   

ġ4 ߻Ͽٸ 

$40,000 x 90% (PPO  :  90 %) -  Deductible $100=$35,900

ȸ翡 κ δ

ϼž մϴ.

 

 3. δ ־ Ҹϴ.

 

4 ѵ ְ CO-pay δ ־ Ҹ ()

 

 5. Annual Out-of-Pocket Maximum$2,500 (Ⱓ δؾϴ δ) Ҹ

 

 

 

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   4 . (б н Immunization

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6. HIV()

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